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The absorption of vitamin B12 may be impaired by proton pump inhibitors (e.g. omeprazol), histamine H2-antagonists (e.g. cimetidine), colchicine, neomycin, and aminosalicylic acid.
Serum levels may also be lowered by oral contraceptives, but this interaction is unlikely to have clinical significance.
Chloramphenicol may attenuate the effect of vitamin B12 in anaemia.
Steroid drugs, such as prednisone, have been reported to increase the absorption of vitamin B12 in patients with pernicious anaemia.
Nitrous oxide (N2O) induces a functional vitamin B12 deficiency.
Metformin may lower the serum levels of vitamin B12.
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